The Institute for Global Health and Development
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9
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Item Refugee integration in national health systems of low- and middle-income countries (LMICs): evidence synthesis and future research agenda(Elsevier, 2025-09-12) Olabi, Amina; Palmer, Natasha; Bertone, Maria Paola; Loffreda, Giulia; Bou-Orm, Ibrahim; Sempé, Lucas; Vera Espinoza, Marcia; Dakessian, Arek; Kadetz, Paul; Ager, Alastair; Witter, SophieThis paper reviews evidence on healthcare responses for refugees, documenting the different approaches and their effectiveness and impact in particular in relation to supporting integrating refugees into national health systems. The review adopted a purposeful, iterative approach, utilizing electronic databases, grey literature, and reference lists from relevant studies. A total of 167 studies, primarily from low- and middle-income countries (LMICs), focusing on refugees and forcibly displaced persons with empirical data, were included. The review highlights a substantial literature on refugee health and healthcare access, with well-covered areas including delivery models, access barriers, gaps in coverage, and specific health services such as psychosocial care, non-communicable diseases, mental health, and maternal and child health. However, less attention is given to integration models, health system responses, and their impact on system resilience and social cohesion. Few studies examine the costs, feasibility, or sustainability of integration models, and little research focuses on health system perspectives or comparative analyses. Moreover, the host health system's status, capacity, and needs are often underexplored. Some countries are particularly well-represented in studies, e.g. Turkey, Jordan, Lebanon, Bangladesh, Democratic Republic of Congo (DRC), and Uganda. There is however a paucity of data that would provide the basis for more quantitative or analytical evaluation from a systems perspective. This gap highlights the need for further research on effective integration models, their operational aspects, and their long-term impact on local health systems' resilience and sustainability. To support this research agenda, we propose a conceptual framework to provide analytic guidance for future research on healthcare responses for refugees and health system integration.Item Women’s Experience of Domestic Violence: A Qualitative Study in Hangzhou, China(Springer, 2024-11-30) Yuan, Weiman; Kadetz, Paul; Shen, Xiaohui; Hesketh, TheresePurpose There has been an increasing awareness of Domestic Violence (DV) in China following the announcement of the First Anti-Domestic Violence Law, in 2015 yet, there has been limited in-depth research concerning DV in China -with most focused on prevalence and risk factors. This study aims to capture female DV victims’ experience of violence in China, and identify the perceived causes and impacts of DV. Methods This qualitative research, conducted from June to September 2019 in Hangzhou, China, consisted of in-depth semi-structured interviews with 30 women who had experience of DV. Social cognitive theory served as the theoretical framework and Interpretive Phenomenological Analysis to analyze the data. Results The most common types of physical violence reported included hitting, throwing objects at women, choking, kicking, and slapping. Psychological violence consisted of insults and denigration, physical threats, and enforcement of social isolation. Sexual violence consisted of forced sexual behaviors against women’s willingness. All informants suffered physical or psychological impacts from the violence experienced. Perceived causes of DV included the perpetrator’s personality and childhood experience of violence; victims’ self-blame; conflict between couples that include those concerning raising children and household finances; family conflicts, especially with parents-in-law; social factors including rural-to-urban migration for work, social norms and constraints, and legal constraints to separation. 80% of informants reported that they still cohabit with their abusive partner. Conclusion Our findings provide insights into potential preventative measures for DV from individual, family, and social perspectives, and the need to de-stigmatize and support victims of DV in China.Item An African One Health network for antimicrobial resistance and neglected tropical diseases [Correspondence](Springer, 2024-01-03) Abd El Wahed, Ahmed; Kadetz, Paul; Okuni, Julius Boniface; Dieye, Yakhya; Frimpong, Michael; Ademowo, George Olusegun; Makiala-Mandanda, Sheila; Woldeamanuel, Yimtubezinash; Eltom, Kamal Hassan; Yeboah, Georgina; Käsbohrer, Annemarie; Kajumbula, Henry; Truyen, Uwe; Nakanjako, DamalieItem Prevalence, drivers and surveillance of antibiotic resistance and antibiotic use in rural China: Interdisciplinary study(Public Library of Science, 2023-08-09) Lambert, H.; Shen, X.; Chai, J.; Cheng, J.; Feng, R.; Chen, M.; Cabral, C.; Oliver, I.; Shen, J.; MacGowan, A.; Bowker, K.; Hickman, M.; Kadetz, Paul; Zhao, L.; Pan, Y.; Kwiatkowska, R.; Hu, X.; Wang, D.This study aimed to characterise antibiotic prescribing and dispensing patterns in rural health facilities in China and determine the community prevalence of antibiotic resistance. We investigated patterns and drivers of antibiotic use for common respiratory and urinary tract infections (RTI/UTI) in community settings, examined relationships between presenting symptoms, clinical diagnosis and microbiological results in rural outpatient clinics, and assessed potential for using patient records to monitor antibiotic use. This interdisciplinary mixed methods study included: (i) Observations and exit interviews in eight village clinics and township health centres and 15 retail pharmacies; (ii) Urine, throat swab and sputum samples from patients to identify potential pathogens and test susceptibility; (iii) 103 semi-structured interviews with doctors, patients, pharmacy workers and antibiotic-purchasing customers; (iv) Assessment of completeness and accuracy of electronic patient records through comparison with observational data. 87.9% of 1123 recruited clinic patients were prescribed antibiotics (of which 35.5% contained antibiotic combinations and >40% were for intravenous administration), most of whom had RTIs. Antibiotic prescribing for RTIs was not associated with presence of bacterial pathogens but was correlated with longer duration of infection (OR = 3.33) and presence of sore throat (OR = 1.64). Fever strongly predicted prescription of intravenous antibiotics (OR = 2.87). Resistance rates in bacterial pathogens isolated were low compared with national data. 25.8% of patients reported antibiotics use prior to their clinic visit, but only 56.2% of clinic patients and 53% of pharmacy customers could confirm their prescription or purchase included antibiotics. Diagnostic uncertainty, financial incentives, understanding of antibiotics as anti-inflammatory and limited doctor-patient communication were identified as key drivers of antibiotic use. Completion and accuracy of electronic patient records were highly variable. Prevalence of antibiotic resistance in this rural population is relatively low despite high levels of antibiotic prescribing and self-medication. More systematic use of e-records and in-service training could improve antibiotic surveillance and stewardship in rural facilities. Combining qualitative and observational anthropological methods and concepts with microbiological and epidemiological investigation of antibiotic resistance at both research design and analytic synthesis stages substantially increases the validity of research findings and their utility in informing future intervention development.Item Rebuilding a New Orleans Community with Food(2008) Kadetz, PaulItem The commodification of the 21st century biomedical male(2009) Kadetz, PaulItem Health and development(2008-11) Kadetz, PaulItem Generating a research centre for food security in Guatemala(2009-02) Kadetz, PaulItem Community Agency, Positive Deviance, and Sustainable Development(2009-11) Kadetz, Paul